In the treatment of endocarditis antibiotics are used against the germs and drugs against the inflammatory reactions, in addition, underlying diseases and sequelae are treated. Often, an additional surgical procedure is necessary.
This is exactly how the treatment of endocarditis looks like:
- The most important pillar of the therapy is the administration of antibiotics - with it already on suspicion begun, before the exciter was proven. The duration of therapy is adjusted individually (usually it is four to six weeks) - especially in rheumatic endocarditis, the antibiotic treatment must be continued over a longer period of time to prevent relapse. In addition, aspirin and cortisone are given in rheumatic endocarditis.
- In severe acute forms and in chronic irreparable secondary damage to the valve apparatus, the heart often needs to be operated on and the inflamed or chronically deformed heart valve replaced by a heart valve prosthesis. This effectively removes the focus of inflammation and improves the performance of the heart. However, artificial prosthesis have two disadvantages: their lifespan is limited and they require a lifelong medicinal blood thinning. Sometimes, the surgeon can repair the defective valve by tightening or stretching so that no artificial prosthesis is needed. As a last resort in severe heart failure after valvular damage is also a heart transplant into consideration.
- In addition, the sequelae of chronic heart valve damage such as cardiac arrhythmia or heart failure are additionally treated individually.
- If the endocarditis occurs as an accompanying reaction in the context of other serious diseases of the organism, such as in chronic polyarthritis, the treatment must be directed to the elimination of the underlying problem, in this case again an immune disease.
Often it is not possible to prevent a first disease, but with the targeted and consistent treatment of the expired endocarditis at least to control the progression of inflammation and valve damage or curb.
Higher risk for those already affected
Once you have undergone endocarditis, you are in principle more at risk of getting it again. Therefore, sufferers - as well as patients with an artificial heart valve and a severe congenital heart defect - for life before any planned diagnostic or therapeutic medical intervention in which germs may enter the bloodstream (for example, tooth removal, gastroscopy, surgeries such as in the nose). Throat area) a preventive - usually unique antibiotics received (Endokarditisprophylaxe).
However, it could be shown that for certain valve defects, several interventions do not lead to an increased endocarditis risk, which is why the formerly strict guidelines were somewhat relaxed in 2007.
In order to prevent the disease from worsening, regular follow-up examinations are also advised to the doctor, in which, if necessary, the drug therapy is also adjusted. In addition, sufferers should have issued a cardiac passport, which they present in all (planned) treatments and should not forget on vacation.
Important for those affected:
- always have the heart passport and submit
- good, regular dental hygiene with a soft toothbrush
- For bacterial infections, let the doctor prescribe early and sufficiently long antibiotic therapy